| National Provider Identifier [NPI]: | 1538447164 |
| Last Name Of The Provider | LATSON |
| First Name Of The Provider | LARRY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.S., M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 E 210TH ST |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY, C/O EMILY OFRIAS |
| City Of The Provider | BRONX |
| Zip Code Of The Provider | 104672401 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 11328 |
| Number Of Medicare Beneficiaries | 1854 |
| Total Submitted Charge Amount | 700170 |
| Total Medicare Allowed Amount | 151080.31 |
| Total Medicare Payment Amount | 114380.7 |
| Total Medicare Standardized Payment Amount | 103661.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 8188 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 29300 |
| Total Drug Medicare AllowedAmount | 1799.62 |
| Total Drug Medicare PaymentAmount | 1410.9 |
| Total Drug Medicare Standardized Payment Amount | 1410.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 3140 |
| Number Of Medicare Beneficiaries With Medical Services | 1854 |
| Total Medical Submitted Charge Amount | 670870 |
| Total Medical Medicare Allowed Amount | 149280.69 |
| Total Medical Medicare Payment Amount | 112969.8 |
| Total Medical Medicare Standardized Payment Amount | 102250.68 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 655 |
| Number Of Beneficiaries Age 75 to 84 | 650 |
| Number Of Beneficiaries Age Greater 84 | 391 |
| Number Of Female Beneficiaries | 999 |
| Number Of Male Beneficiaries | 855 |
| Number Of Non Hispanic White Beneficiaries | 1489 |
| Number Of Black or African American Beneficiaries | 108 |
| Number Of AsianPacific Islander Beneficiaries | 77 |
| Number Of Hispanic Beneficiaries | 121 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 59 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1421 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 433 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.1199 |